Key result
HF preceding AF linked to ~5% lower survival versus the reverse sequence in obese T2D.
Why the study?
Obesity and type 2 diabetes increase the risk of heart failure and atrial fibrillation, but the temporal sequence of their onset is poorly characterized.
Population
205k adults with T2D, obesity, and incident AF and HF without prior stroke
Comparison
AF→HF vs same day AF=HF vs HF→AF trajectories
Design
Retrospective cohort study
Authors
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HF preceding AF may identify higher-risk obese T2D patients; leaves open distinct phenotypes and need for prospective validation.
Cohort (n=205,000)
Absolute Event Rate: 62.2% vs 67.2%
In patients with obesity and type 2 diabetes, the temporal sequence of developing heart failure before atrial fibrillation is associated with worse long-term survival and higher stroke risk compared to developing atrial fibrillation first.
RUSSO et al. (2026) conducted a cohort in Obesity and Type 2 Diabetes (n=205,000). Heart failure preceding atrial fibrillation (HF→AF) vs. Atrial fibrillation preceding heart failure (AF→HF) was evaluated on 72-month survival. In adults with obesity and type 2 diabetes, developing heart failure before atrial fibrillation was associated with lower 72-month survival compared to the reverse sequence (62.2% vs 67.2%).
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